A Michigan judge has slapped former USA Gymnastics doctor Larry Nassar with an additional 40-125 years in prison after the shamed physician pleaded guilty to three more counts of sexual misconduct, this time in Eaton County.

“I am not convinced that you truly understand that what you did was wrong and the devastating impact that you’ve had on the victims, family and friends,” Judge Janice Cunningham said Monday as she announced the decision. “I believe this sentence is proportionate to the seriousness of the circumstances surrounding the offenses and of the offender.”

Prior to the sentencing, Nassar briefly addressed the court and apologized for his actions. Dressed in an orange prison jumpsuit with shackles around his waist, he read from note cards and said that the victim statements given in court had “impacted me to my innermost core. I understand that pales in comparison to the pain, trauma and emotions that you all have felt.”

The 54-year-old listened to dozens of victims for two days last week, and was nearly attacked by a father whose three daughters said they were abused by Nassar.

It is the second sentencing in almost two weeks. On Jan. 24, he was sentenced to up to 175 years in prison after Ingham County Circuit Court Judge Rosemarie Aquilina handed him the term. His sentence came after Judge Aquilina allowed days of often emotional victim impact statements — 156 in total — from former patients or their family members, all sharing stories of abuse at Nassar’s hands.

He was previously sentenced to 60 years in prison following his conviction on child pornography crimes.

More than 260 women and girls say they were assaulted by Nassar, including 2012 Olympic teammates Aly Raisman, Jordyn Wieber and McKayla Maroney.